Stress Thallium-201/Rest Technetium-99m Sequential Dual Isotope High-Speed Myocardial Perfusion Imaging

被引：120

作者：

Berman, Daniel S. ^{[1
,2
,3
]}

Kang, Xingping ^{[1
,2
]}

Tamarappoo, Balaji ^{[1
,2
]}

Wolak, Arik ^{[1
,2
]}

Hayes, Sean W. ^{[1
,2
,3
]}

Nakazato, Ryo ^{[1
,2
]}

Thomson, Louise E. J. ^{[1
,2
]}

Kite, Faith ^{[1
,2
]}

Cohen, Ishac ^{[1
,2
]}

Slomka, Piotr J. ^{[1
,2
,3
]}

Einstein, Andrew J. ^{[4
,5
]}

Friedman, John D. ^{[1
,2
,3
]}

机构：

[1] Cedars Sinai Med Ctr, Dept Imaging, Div Nucl Med, Dept Med,Div Cardiol, Los Angeles, CA 90048 USA

[2] Cedars Sinai Med Ctr, CSMC Burns & Allen Res Inst, Los Angeles, CA 90048 USA

[3] Univ Calif Los Angeles, Sch Med, Dept Med, Los Angeles, CA 90024 USA

[4] Columbia Univ, Dept Med, Med Ctr, Div Cardiol, New York, NY USA

[5] Columbia Univ, Med Ctr, Dept Radiol, New York, NY USA

来源：

JACC-CARDIOVASCULAR IMAGING | 2009年 / 2卷 / 03期

关键词：

dual isotope imaging; high-speed SPECT; myocardial perfusion imaging; coronary artery disease; EMISSION COMPUTED-TOMOGRAPHY; CORONARY-ARTERY-DISEASE; CLINICAL VALIDATION; TL-201; SUPINE; PRONE; REST;

D O I：

10.1016/j.jcmg.2008.12.012

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

OBJECTIVES Our purpose was to describe a novel, rapid stress thallium-201 (Tl-201)/rest technetium-99m (Tc-99m) agent myocardial perfusion imaging (MPI) protocol (Tl/Tc) with a high-speed MPI scanner and to compare this protocol with a standard rest/stress Tc-99m agent protocol (Tc/Tc) with respect to image quality and radiation dosimetry. BACKGROUND Recent advances in gamma camera technology have provided opportunity for improved SPECT MPI protocols. A rapid Tl/Tc protocol that could improve image information while maintaining a low radiation burden for the patient would be desirable. METHODS We compared high-speed SPECT MPI studies in 374 consecutive patients undergoing exercise or pharmacologic Tl/Tc protocol to those of 262 patients undergoing rest/stress Tc/Tc protocol. RESULTS Tl/Tc imaging was accomplished in <20 min. Overall image quality was good to excellent in 96% and 98% of patients with the Tl/Tc and the Tc/Tc protocols, respectively (p = ns). Beginning rest imaging within 2 min after rest injection with the Tl/Tc protocol did not result in reduced confidence in image interpretation. Early rest Tc images of the Tl/Tc protocol showed less extracardiac activity than was observed on standard rest imaging used in the Tc/Tc protocol (84% vs. 61%), respectively (p < 0.01). The normalcy rate was high in both groups (100% vs. 92%). Radiation burden was similar between the Tl/Tc and Tc/Tc protocols. CONCLUSIONS A rapid stress Tl-201/rest Tc-99m protocol for use with high-speed SPECT MPI has image quality and radiation dosimetry similar to those observed with a conventional rest/stress Tc-99m protocol. The Tl/Tc protocol offers promise as an efficient and relatively low radiation dose method, in which the superior qualities of Tl-201 for stress imaging and of the Tc-99m agents for rest imaging can be preserved. The findings also suggest that with rapid imaging rest MPI immediately after Tc-99m agent injection may be superior to standard delayed image initiation. (J Am Coll Cardiol Img 2009;2:273-82) (C) 2009 by the American College of Cardiology Foundation

引用

页码：273 / 282

页数：10

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